DELEGATION

in the
CLINICAL SETTING

What is DELEGATION?
“Transferring to a competent individual the authority to perform a selected nursing task
in a selected situation. The nurse retains the accountability for the delegation.”

Why delegate?
enables one to accomplish all that is expected of them
allows outcomes to be achieved in a timely, cost-effective manner
contributes to employee’s personal and professional growth
we delegate based on desired patient outcomes

What do you need to delegate?

a delegator
a delegatee
an activity, task, or job
the transfer of responsibility/authority

What will dictate what you delegate?

Nurse Practice Law of a particular state
Job description, policies, and procedures of the agency
“Let whoever is in charge keep this simple question in her head (NOT, how can I always
do the right thing myself but) how can I provide for this right thing always to be
done?”

SUPERVISION
“The provision of guidance or direction, evaluation and follow-up by the licensed nurse
for accomplishment of a nursing task delegated to unlicensed assistive personnel.”
(NCSBN position paper, 1995)

ACCOUNTABILITY
“Being answerable for what one has done, and standing behind that decision and/or
action.” (Hansten and Washburn, 1994)
Delegate, Supervise,
and beAccountable
You are accountable for:
making the decision to delegate
assessing the client’s needs
planning the desired outcome
assessing the delegate’s competency, and
giving clear directions and obtaining acceptance from the delegatee

Four Rights of Delegation

Right task
Right person
Right communication
Right feedback
RIGHT TASK
Determine what needs to be done and decide if tasks can be delegated
Be familiar with Nurse Practice Act
Know employee job descriptions, skills checklists, and demonstrated competencies
Consider, what can I not delegate? (Assessment, planning, nursing diagnoses, and
teaching)
Match the right person with the right task
RIGHT PERSON
Focus on outcomes and strengths and weaknesses of team members
Remember, matching the right person with the right task is the second step of the
delegation process
RIGHT COMMUNICATION
Clearly communicate client outcomes and expectations
Achievement of client outcome is dependent upon the direction you give and how it is
given
Do not assume others know what you need
FEEDBACK FORMULA
Ask for the other individual’s input first
Give credit for effort
Share perceptions with one another
Explore different viewpoints, focusing on outcomes
Determine what steps may be necessary to assure that certain desired outcomes are
achieved
Agree on future plan, revisit plan and results
And, remember:
We delegate based on patient outcomes

Four C’s of Clinical Delegation

Clear
Concise
Correct
Complete